Anxiety - Oxford Health NHS Foundation Trust



Neuro Developmental Conditions PathwayAnxiety50252815104800What is anxiety?Anxiety is a feeling of worry or fear that everyone experiences from time to time. A certain amount of anxiety can enhance our performance, but too much anxiety can interfere with our day to day life (e.g. it may lead to avoidance of certain situations). For more information, see and ASDIt is estimated that around 10-15% of the general population experience an anxiety disorder at some point in their life. However, this percentage is much higher in individuals with ASD, and it is estimated to be around 40%. Individuals with ASD often experience social anxiety because they find social situations difficult. Also, many young people with ASD worry excessively that certain routines might be interrupted, or that they might be prevented from doing certain activities or behaviours. There are several reasons why someone with ASD may experience increased anxiety, including:Intolerance of uncertainty: Young people with ASD prefer routine as it gives structure and predictability, which helps them to make sense of the world. Changes, whether big or small, can therefore cause heightened anxiety. Theory of mind: Many individuals with ASD are unable to infer what others are thinking or feeling. This inability to construct a theory of mind may underlie some of the behaviours and symptoms that characterise ASD but also their increased vulnerability to anxiety.An acute sense of right and wrongness: Following rules and expecting everyone else to follow the same rules.Executive functioning skills (such as those that enable us to organise, plan, and prioritise) may be impaired. It can therefore be more difficult to organise our day, problem solve and think of alternative ways of managing. Sensory: Young people with ASD experience sensory differences, such as, being averse to certain smells and noises. Understandably, school can be a stressful environment due to the number of sensory stimuli (e.g. crowds, food smells, noise). Difficulties understanding emotions: Individuals with ASD can find it challenging to understand their own emotions, but also to read the emotions of others.How might anxiety affect people with ASD?Anxiety will affect people in different ways. For example, some people may:Shut down altogether and become more withdrawnBecome more rigid in their thought processesBecome controlling or oppositionalBecomes angry, aggressive, or violent (towards others or self)How to helpIt is important to try to understand the trigger for the anxiety. You could do this by asking ‘what am I most worried about?’, ‘what is the worst that could happen?’. Another idea is to complete a diary to look for patterns in anxious behaviour. Physical activity and regular exercise can release anxious energy in our bodiesRelaxation activities (such as listening to calming music, and controlled breathing) can alleviate stress. Spending time engaged in a special interest may act as a distraction to anxious thoughts.Spending time with a pet or special person with whom they feel safe (or looking at photos of them!)Studies have shown that diets rich in whole foods, fruit, vegetables, complex carbohydrates and lean protein can have a positive effect on sleep and mood. Behavioural tools, such as visual timetables, social stories and comic strip conversations, can be helpful to increase understanding and predictability of situations. If the level of anxiety requires targeted mental health support, Child and Adolescent Mental Health Services (CAMHS) may offer a range of talking therapies (such as Cognitive Behavioural Therapy) and/or medication. Other resources National Autistic Society your Child with Fears and Worries by Cathy Creswell and Lucy Willetts (book)Young Minds UK Juice AppsCalm: Guided meditation app for young people and adults. DreamyKid: This app offers meditation, guided visualisation and affirmations for children and young people. Headspace: Guided medication to manage stress and anxiety. Thought Diary: An app to record thoughts and emotions. ................
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